Tag Archives: treating pain

Hospitals Reduce Opioid Dispensing in Response to Epidemic

More hospitals are changing their policies about dispensing opioids to emergency room and surgical patients. Drugs like OxyContin, Vicodin and fentanyl, which are prescribed to temporarily provide relief for moderate to severe pain, have also caused irreparable damage. It’s difficult to determine how many people who currently have an addiction to opioids were first exposed to the drugs at a hospital, but it is often where people first encounter them.

Hospital patients aren’t the only ones who were at risk of becoming addicted to painkillers. People who were prescribed large amounts of this class of drugs would often end up with leftover pills. More than 50 percent of Americans who misuse opioids get them from friends or family members, according to the National Survey on Drug Use and Health.

Now there is an increasing number of hospitals and other medical practices that are reducing the number of pills being prescribed for pain. Doctors are saying that opioids are not the only choice for treating acute pain and that less potent options are often just as effective. In the past six months, Rush University Medical Center has given patients recovering from surgery ibuprofen, acetaminophen and gabapentin, which is used to treat nerve pain. A mild opioid medication is used to treat sharper spikes of pain and more acute pain.

Dr. Asokumar Buvanendran, a pain specialist at Rush University Medical Center, said that patients were “more satisfied” with the new protocol. It represents a trend that is hopefully leading more people away from these deadly drugs.

According to experts, opioid use skyrocketed in the 1990s when doctors started prescribing them to patients much more often. During this time, physicians were influenced in their choice to provide medicines in this class to patients by aggressive pharmaceutical company marketing tactics.

Rethinking Approach to Treating Pain

Most of the opioids were given to chronic pain patients. They were also the first choice for post-surgical pain or for patients visiting emergency rooms complaining of pain.

Doctors had the idea that drugs didn’t cause addiction; abusers were solely responsible for their own plight if they became addicted. Research has now shown that the properties of the drugs themselves change brain chemistry in users to cause the addiction.

New Opioid Prescribing Guidelines Help Doctors Make Better Decisions

Northwestern Medicine now talks to patients about the dangers of opioids before surgery. Patients are asked to bring any unused medication to follow-up appointments with their surgeon, so that the drugs can be disposed of safely.

All doctors in the state are required to enroll in a database to monitor painkillers and prescriptions that are commonly abused, a measure to seek out those who may be “doctor shopping” to get drugs. Some hospitals have similar in-house systems.

The Centers for Disease Control and Prevention has called for doctors to prescribe a maximum of seven days’ worth of opioids for patients to take home for acute pain. Many emergency departments today are only giving out 24 – 72 hours’ worth of pills.

While some chronic and severe pain patients may feel these tougher prescribing practices are prohibitive to their care, hopefully there is some comfort knowing that their inconvenience could be contributing to saving lives.

Former Addicts Have Higher Risk of Abusing Painkillers

painjournalAchieving and maintaining sobriety may be one of the most difficult things a person can do in life. Drug and alcohol addicts generally have a high relapse rate, so a thorough aftercare plan is very important to maintaining long-term sobriety. Attending meetings, talking with a counselor, and staying away from drugs and alcohol are important components post-treatment recommendations.

Recently a study conducted by researchers at the Cleveland Clinic and published in the Journal of Pain discussed the likelihood of former addicts misusing therapeutic painkillers. They found that it is important for doctors to understand their patient’s history before prescribing narcotic painkillers.

“Cross addiction is a well-studied phenomenon in which patients recovering from one substance are encouraged to avoid all mind altering substances,” explained Dr. Sylvester Sviokla. This is mostly due to a person’s inclination to take anything that will alter their senses. If the person cannot take their drug of choice, they are easily persuaded to take a different drug. When a patient complains of pain it is vital for physicians to get a complete history so as to eliminate the threat of prescribing narcotic painkillers to a patient who has had problems with addiction in the past, or at least to monitor the patient closely if they are needed.

The study followed almost 200 patients that were formerly addicted to other substances and had problems with pain. Researchers found that patients who had never been addicted to a drug or alcohol had a 25% chance of becoming addicted to narcotic painkillers. On the other end, 83% of former addicts were likely to abuse painkillers, even if they were prescribed for a legitimate problem.

In order to avoid aiding patients to relapse, it is vital that doctors have a complete history of prior drug use. Discussing all the risks associated with taking prescription painkillers is also advised, as well as finding other solutions to the pain that do not involve substances with such a high potential for abuse, if at all possible.